Brand name: CosmoFer®

Instructions for administration of Iron Dextran injection is confusing because there are various different ways to do it, and I have tried to simplify the explanation (though only for IM injection).

This is a parenteral iron preparation, for patients where oral iron supplementation is ineffective, or rapid restoration of iron stores is required. It can be given either as IV injection, IM injection, or IV infusion. Slower, intermittent IV infusion is preferred because this reduces the risk of anaphylaxis, but it is noted the examiner has stated IM injection.

This is classed a moderate-risk product.

• The main risk with Iron dextran is anaphylaxis. A test dose (25mg) is recommended before each dose even if the patient has had it before. After test dose is given, observe patient for 60 minutes for signs of anaphylaxis. Resuscitation equipment is required on hand. Give the rest of the dose if the patient is fine.
• Total dose required is calculated according to the patient’s iron levels, their body weight and their target iron level. The total dose is split up and given over a few days or weeks, for example one vial injected once a day until target level is reached. (Less frequently for inactive or frail patients.)
• IM injections are given by deep injection into the muscle of the buttock. Alternate buttocks and injection sites for subsequent injections.
• It can be diluted with NaCl 0.9% or glucose 5% solution
• Even though the examiner has requested IM injection, note that IM administration is not recommended due to incomplete absorption and pain on injection.
• Observations: hypersensitivity/anaphylaxis.
• Oral iron should not be given until 5 days after the last injection, because IV iron stops it from working

Ref:

Summary of Product Characteristics (SPC)

Treatment of iron deficiency anemia associated with gastrointestinal tract diseases, World Journal of Gastroenterology. 2010 Jun 14; 16(22): 2720–2725.